Acromegaly / by Maximilian Sternberg ; translated by F.R.B. Atkinson.

  • Sternberg, Maximilian, 1863-
Date:
1899
Catalogue details

Licence: Public Domain Mark

Credit: Acromegaly / by Maximilian Sternberg ; translated by F.R.B. Atkinson. Source: Wellcome Collection.

Provider: This material has been provided by Royal College of Physicians, London. The original may be consulted at Royal College of Physicians, London.

    66/186 (page 62)
    Our picture shows such a one very plainly on the metacarpal hone of the index finger. In some cases the hones of the fingers show a decided increase of growth in length, through participation of the epiphysis, so that the hand becomes not only broadened but lengthened. It then appears as if the hand should belong to a much bigger individual than its actual owner. It is possible also to distinguish with (6) Marie two types which represent extremes. The one type is more general; the broadened, massive, acromegalic hand, “ main en battoir,” “ type en large ” ; the other represents an entirely enlarged giant hand, the “ type en long,” “ type geant.” We give in Tig. 16 (p. 61) an illustration of both types, after a photograph kindly sent by P. Marie. The massive type is also well shown in Figs. 12 and 14. Marinesco has examined both types by the Röntgen rays. In the massive type the hypertrophy of the soft parts is much more marked than in the giant type. The thickening of the diaphysis must, however, be also taken into account in some degree to explain the shape of this hand. Great alterations in the digital joints are rare. Henrot and Gauthier saw nodulated thickenings. The whole enlargement of the hands begins from the wrists ; these are very slightly, and the forearms not at all affected by the morbid increase in size. The characteristic appearance of the extremity in acromegaly is due to the contrast between the giant hand and the disproportionately slender arm which bears it. In many cases this disproportion is increased by atrophy of the muscles. The feet, like the hands, become substantially coarser and heavier with deepened wrinkles and enlarged folds. They are frequently flat. The enlargement terminates at the ankles. Regarding the actual proportions and the amount of increase in size of the terminations of the extremities, the articles of dress, as gloves and shoes, and as the disease ad- vances, rings and thimbles, often provide us with a fail- amount of reliable information (e.g., Terstraeten). The shoes are especially valuable in such lands as Xorth America, where they are almost exclusively factory productions. Several